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What was nursing like 50 years ago?

Fifty years ago, no person over the age of 35 was admitted to nursing school, segregation was common in the patient wards, and mashed baby food was prescribed to treat open wounds. These were some of the practices that our student Amanda Schubert discovered when she interviewed alumna Beverly Ervin for Goldfarb School of Nursing at Barnes-Jewish College’s student newsletter, Vital Signs.

Read on to see what else she found out:

Recently, I had the opportunity to talk with an alumnus of our nursing school who graduated in 1960. Her name is Beverly Ervin and, at the time of her graduation, the school was known as the Barnes Hospital School of Nursing, which of course was before the 1996 merger of Barnes Hospital and Jewish Hospital. Beverly recently celebrated her 50-year class reunion in March 2010 at an alumni function hosted at the college. Over her 50-year career as a nurse, Beverly has worked in numerous specialties, with more than 40 of those years spent working at Barnes-Jewish Hospital. Today, she continues to work at Barnes-Jewish on the newly remodeled observation unit (16400), providing care to patients recently transplanted with new kidneys and livers.

In addition to her long and established career at the hospital, Beverly has traveled to Haiti more than 27 times to provide bible ministry, education and medical care to residents of a rural town a few hours outside of the capital of Port-au-Prince. On more than one occasion during her two-week trips, Beverly was the only nurse in attendance, spending long hours treating and educating hundreds of patients daily, which I think is incredibly brave. Upon meeting Beverly, I instantly felt a sense of calm because of her unassuming and easygoing nature. She is a great conversationalist who easily answered any and all of my questions on diverse topics. When I asked her what it is that has kept her in nursing for so many years, she answered quickly and honestly, “Every patient is truly different, and every day is truly different.” We talked about the fact that nursing has always provided her with continued opportunities to learn and interact with people.

As our conversation continued, a discussion ensued regarding the differences in nursing education and practice over the years. She provided me with an interesting, personal glimpse into the profession of nursing in St. Louis when she was new nurse.

In 1957, Beverly, a native of St. Louis, was 17 years old and just beginning a three-year nursing diploma program at Barnes Hospital School of Nursing. At that time, the nursing students, who were all female, were required to live in the dormitories on campus even if they were married. No person over the age of 35 was admitted to the program and curfews were especially strict for freshmen, with most evenings ending at 9 p.m. Also, social events were planned regularly with the medical students on campus but the men were not allowed in the nurses’ dorms above the first floor because, as Beverly puts it, “The instructors worried about the hanky-panky that might ensue.”

The education required of the nursing students consisted of all the familiar courses like anatomy and physiology, pharmacology, medical-surgical nursing and so forth. Beverly argued, however, that the “most marvelous learning experience” was working immediately in the hospital – after six months of school, the students were actually in charge of the nursing divisions. Essentially, Beverly explained that the students became the charge nurses of certain divisions on the open wards in which they worked during school, which for the most part was on the night shift. The use of open wards is certainly a bygone concept in today’s medical system. These wards can be best described as entire floors of a hospital that were completely open, with no private or semi-private room separation and rows of patients in beds lined up and down the walls. Furthermore, Beverly explained that all the patients were divided into separate wards by gender and race. She said the segregation practice was finally terminated in the early 1960s when Mr. Edgar Queeny became the chairman of the board at Barnes Hospital.

There were many other significant differences regarding the educational practices of the time. For instance, the cost of her education, with food and board included, only totaled a mere $400 for the entire three years of nursing school; an experience she described as “a world class education on a shoestring budget.” The nursing uniforms of her day were another point Beverly mentioned as being “distinctly different” from today’s traditional nursing scrubs – as a student, a blue cotton dress with a bib, apron, white cap and the dreaded seamed hose were standard. On each nurses’ cap were ribbons or bands that denoted your year in school, and as Beverly was keen to point out, “Were well known by the doctors and used by them to distinguish the rookies from the seniors.”

A pink band stood for freshman year and juniors wore light blue bands. The seniors wore royal blue bands, which also carried over into graduation as a new nurse along with the change into the white dress uniforms of a registered nurse. A professional appearance standard was strictly enforced upon the students at all times and entailed line-up checks of hair, nail and ear cleanliness by the nursing directors of the hospital divisions. Sometimes, if the directors were not satisfied with their appearance, they would order the students to not come back for duty until getting a haircut, especially if the hair touched their collars, and to look more “crisp” for the next inspection.

When Beverly graduated in 1960, there were many medical practices in place that have become obsolete over time as technology has taken over the medical arena. For example, doctors and nurses still treated patients with O2 tents and Iron Lungs, night nurses sterilized and reused metal bedpans, hospital sugar was used to treat small decubitus ulcers and oftentimes jars of mashed meat baby food was prescribed to treat open wounds. To top it off, there was no such thing as IV medicine and there were certainly no ICUs or complex monitoring equipment. It was common to have an open craniotomy patient in a bed next to a simple hernia repair in the open ward.

Furthermore, Beverly indicated that there was sentiment at the time that the nurses were not competent enough to draw blood. Therefore, the common practice of the time was that the medical interns or residents were required to draw all hospital patients’ blood samples in the early morning. Also, depending on what Beverly called “the idiosyncrasies of the head of each department division,” nurses may or may not have been able to catheterize patients or apply sterile dressings depending upon the wound. Interestingly enough, she said that they were always able to drop an NG tube without question.

Needless to say, Beverly has been witness to many hospital and nursing policies as well as many medical care practices that have changed drastically over the years. She admits that some of the nurses coming out of school now have a superior grasp than she or some of her peers do on some nursing and medical interventions on a technological level. However, she was keen to emphasize that while technology may change, the fact is that “the needs of our patients really never change and these needs demand the art of nursing skills that I possess as a compassionate caregiver.”

All in all, Beverly said that the most important lesson she learned in her 50-year career is that the nurses – new or seasoned – who actually built rapport with their patients as people are far more successful in their interactions and in their careers. This is a lesson that all of us should take to heart.

-Amanda Schubert, BSN ‘11

Amanda is a student in the Accelerated BSN program. A native of Denver, she earned a bachelor’s degree in integrative physiology from the University of Colorado at Boulder. She was a clinical research data manager for a Phase I clinical trials program at the University of Colorado Cancer Center. When she moved to St. Louis in 2009, she worked for the clinical trials core at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

During nursing school, Amanda served as editor of the Vital Signs student newsletter and was an active member of the Sigma Theta Tau Honor Society of Nursing. In addition, she served as a peer leader and peer mentor to fellow Accelerated students – leading review sessions on pathophysiology, adult health and medical-surgical nursing. She is graduating at the end of this month.